Stanford Emergency MedicineA unique design for children

Bewildered. Frightened. Anxious. A dash to the emergency room with a worried parent can strand a sick or hurting child seriously out of his or her comfort zone. It can even complicate diagnosis and treatment efforts. The new emergency medicine department shared by Lucile Packard Children's Hospital and Stanford Hospital & Clinics alleviates this problem by combining Packard Children's trademark kid-friendly atmosphere with a coterie of pediatric emergency medicine specialists familiar with their young patients' needs and anxieties.

"No physician can do an adequate lung or abdominal exam on a screaming child," explained Bernard
Dannenberg, MD, emphasizing that children respond differently than adults to the institutional, utilitarian feel of many emergency facilities. "We are now able to reduce a child's anxiety through play and distractions such as movies and games, which allows us to get a better exam and ultimately arrive at the answer we need much faster." Dannenberg is the director of pediatric emergency medicine at Packard Children's and a clinical assistant professor of surgery.

The new emergency facility, reached through the adult Emergency Department, is a triumph of partnership. Packard Children's, Stanford Hospital & Clinics, the Lucile Packard Foundation for Children's Health and more than 50 individual donors from the community banded together to make a child's unplanned hospital visit less scary and more efficient. In the process they created a new standard of pediatric emergency care.

Now, rather than waiting with sick adults in a non-descript room, most of the 11,000 children per year who visit the 24-hour facility follow a blue river pattern in the floor to a brightly lit and colorful waiting room decorated with familiar storybook artwork and whimsical patterns, and stocked with toys and activities for the children. Each of the seven exam rooms has a television, computer games, music, movies and Internet access. The pediatric emergency department is staffed by teams of pediatric specialists, from physicians and nurses to child-life specialists, who can respond to medical problems ranging from minor to life-threatening. Dannenberg himself has completed medical residencies in both pediatrics and emergency medicine -- rendering him uniquely able to treat medical emergencies in the smallest of patients in the new facility.

"We have everything necessary to take care of children," explained Dannenberg. "Monitors in every exam room allow constant observation of a patient's vital signs from a central nursing station, and the exam rooms' headboards are equipped with the latest in medical technology. In addition, two of the exam rooms can function as isolation rooms, providing negative air pressure to isolate children with communicable diseases."

Although most children can be adequately cared for in a normal emergency department, pediatric emergency departments affiliated with children's hospitals have some unique advantages above and beyond the child-friendly atmosphere. Packard Children's tertiary care facility represents all pediatric specialties, and routinely accepts severe pediatric trauma and pediatric intensive care cases referred from surrounding community hospitals.

"All of us who work in emergency medicine are thrilled about what this means for kids and their families," said Stanford Hospital emergency medicine chief and associate professor of surgery Robert Norris, MD. "This new department will also enable us to advance the research and teaching of pediatric emergency medicine through training programs and fellowships."